Lower limb edema .
The lower-limb edema may be unilateral or bilateral and takes on different meanings. The review will also look at whether it is of acute onset or is chronic. In all cases, we will consider whether the edema is venous or lymphatic.
Venous edema is often a soft swelling, Pitting, with increased local heat and increasing standing.
The lymphatic edema is rather firm, does not the bucket. The blue test is abnormal in that the injection of patent blue subcutaneously is not accompanied by a reduction along the lymphatic channels but spreadsheet under the skin.
LACE OF VARIOUS TESTS IMAGING
In suspected cases of phlebitis, The Doppler confirms the diagnosis and clarifies if possible the seat of the clot. If it is proximal (iliofemoral) , the risk of embolism leads to practice venography, which can be supplemented if necessary by placing a filter endoluminal if the edema is unilateral but incurable. The venography looked for arguments in favor of a chronic phlebitis. If venography is normal, the etiology lymphatic will be demonstrated by a test and a blue lymphatic blockage by lymphography.
Edema can finally have a cause the joint compression process, especially in the scarpa; it can be caused by arteritis or an arteriovenous malformation as Klippel-Trenaunay.
If the edema is bilateral, after eliminating the general causes, will seek a reciprocal phlebitis or compression by a cave venography. The absence of a venous anomaly will find a lymphedema and its causes. Note that the compression or invasion by a retroperitoneal process, edema is often mixed and lymphatic.
QCM 13.1: before a vein substitute suprapubic , what is the diagnosis to evoke ?
A - iliac vein thrombosis,
B - arteritis associated,
C - valvular insufficiency,
D - SVC thrombosis,
E - sural thrombosis,
QCM 13.2: Radiological signs which can be seen in the aftermath of DVT when venography performed in the lower ?
A - irregular contours venous ,
B - gaps in the image cup, surrounded by the contrast,
C - laminated aspect of the venous system,
D - pack vascular
E - arteriovenous fistula .
QCM 13.3: A patient has bilateral edema of the lower. Phlebography revealed extrinsic compression of the inferior vena cava. The examinations for first-line guiding the etiologic diagnosis are:
B - aortography ,
C - abdominopelvic CT ,
D - cavography by jugular
E - MRI pelvis .
QCM 13.4: What is the review to be carried out before a unilateral chronic swelling of the lower limb? When the Doppler is normal?
A - pelvic CT ,
B - cavography,
C - after lymphography blue test ,
D - arteriography ,
E - Monitoring .
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